Provider Demographics
NPI:1003947607
Name:COMMUNITY INTERACTION OF OHIO LLC
Entity Type:Organization
Organization Name:COMMUNITY INTERACTION OF OHIO LLC
Other - Org Name:COMMUNITY DEVELOPMENTAL CENTER INC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER & DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FODAY
Authorized Official - Middle Name:L
Authorized Official - Last Name:TURAY
Authorized Official - Suffix:SR
Authorized Official - Credentials:STILL IN COLLEDGE
Authorized Official - Phone:614-432-7266
Mailing Address - Street 1:479 RADCLIFF DR
Mailing Address - Street 2:479 RADCLIFF DR
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-6356
Mailing Address - Country:US
Mailing Address - Phone:614-432-7266
Mailing Address - Fax:
Practice Address - Street 1:479 RADCLIFF DR
Practice Address - Street 2:479 RADCLIFF DR,
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-6356
Practice Address - Country:US
Practice Address - Phone:614-432-7266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1584764251E00000X
PA1024531420002314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2558530OtherDODD
OH0059241Medicaid
PA1024531420002OtherODP/ MRDD